What is Tinnitus

Tinnitus Definition

Tinnitus is the perception of noises in the ear which correspond to the lack of an acoustic signal in the environment. The buzzing, ringing tinnitus is the perception of the individual of noises or sounds that do not come from the outside. These sounds are, however, produced by the patient himself/herself.

Tinnitus corresponds to the buzzing or hissing sounds heard in one or two ears, or in the head, in the absence of any physical source in the surrounding environment.

The sounds heard can be of various natures: low tone pure sounds (buzzing), high-pitched (hissing), continuous or pulsating, etc… However, the sounds perceived by the subject are mostly complex and can be similar. For example, to the sound of a bell, hissing, a steam noise, an engine, a grating, a cicada/cricket sound.

The tinnitus is not strictly speaking an auditory hallucination (AH). It can be distinguished from AH by the rudimentary contents of the noises heard (pure sounds or more or less wide-band frequency noises devoid of sense or direction) and by the fact that the patient is aware that they originate from his/her own body.

It results from the production of an abnormal neural signal at a particular level of the auditory pathways which, after being processed by such pathways, is interpreted as a noise when it reaches the auditory cortex.

Given that there is no external source of noise, the sound received is an auditory hallucination created by a reorganization at the level of the cerebral cortex following the loss of auditory acuteness in the frequency of the tinnitus. That is why people who suffer from tinnitus avoid speaking about it too much for fear of being taken for hallucinating persons!

People who suffer from tinnitus hears a ghost noise produced by the part of the brain which is not stimulated by the usual noises at frequencies which one does not hear any more, given the loss of auditory acuteness in the zone corresponding to the frequencies of the tinnitus.

Regarding the origin of tinnitus, the theory that is most widely recognized is the existence of an external hair cell lesion. In particular, an alteration in the stereohairs attached to the external hair cells would induce the uncoupling of the tectorial membrane. This would lead to a hyperexcitability of the auditory nerve because of the excessive release of glutamate, which would be at the origin of the perceived sounds. A sound trauma can therefore lead to a lesion of the IHC which is visible with the use of electronic microscopy.

Two types of tinnitus

Objective tinnitus

refers to the few cases in which the noises heard results either from vascular abnormalities or from abnormal contractions of the muscles of the O.R.L . sphere, or from structural defects of the internal ear.

Subjective tinnitus

mostly originates from any level of the auditory pathways, from the external conduit of the ear up to the brain.

Statistics

  • Worldwide prevalence is 10 to 17 % of the population that would be affected
  • 44 million Americans suffer from it among which 12 millions are severe cases
  • Canadian Tinnitus Association accounts for more than 5 million cases
  • One young person in five faces risks of deafness because of the noise and, because of the lack of large-scale epidemiological studies to provide statistics. It is considered that 10 % and 20 % of them are hearing-impaired. It would be necessary to add to these figures the young people suffering from tinnitus and from hyperacousis.

Certain Known Causes

  • Sudden Deafness
  • Auditory Trauma (concert, limps at night, firecracker, fireworks)
  • Hearing Loss
  • Cranial trauma (particularly after fractures)
  • Neurinome and tumor of the ponto-cerebellar angle
  • Medicines and drugs (aspirin, diuretics, aminoglycosides, quinine)
  • Cervical and mandibulary problems
  • Dental problems
  • Chronic Infections
  • Otosclerosis
  • Ménière Disease (or dizziness)
  • High Blood Pressure Hypertension
  • Severe Anaemia and Renal Insufficiency
  • Borréliose
  • Stress or depression

Certain medications may cause tinnitus in individuals.

Ototoxic medications: certain antibiotics (especially those in the class of aminosides administered intravenously for treatment of systematic or generalized infections), diuretics, anti-paludism medicines (against malaria), anti-cancerous medications and certain analgesics (salicylates such as aspirin) indicate in their product description the risk of toxicity for the ear as a side effect.

Nutrition can also have an incidence on tinnitus, for instance: excessive consumption of caffeine, alcohol, drugs, spicy products, etc.

We shall also note that the psychological factors (stress, anxiety, disturbing emotional event, depression) can influence, stress, or even reveal tinnitus. The disturbance caused by the tinnitus is not necessarily related to its intensity but rather to the perception felt by the individual towards this unwanted and sometimes so tenacious noise.

Retraining for tinnitus

Neuropsychology teaches us that stimulus sounds that are new or associated with a negative experience are treated as significant sounds and evoke an emotional response which prepares the body for a reaction of flight or confrontation. The repetition of these sounds is translated by an intensification of their perception and a resistance to their suppression by other stimuli.

In contrast, the repetition of neutral signals are accompanied with the progressive fading of the induced responses, which corresponds to the phenomenon of habituation.

The outcome of a tinnitus devoid of emotional meaning for the subject is thus the habituation. PAXX is a personalized device that helps people with tinnitus habituate their brain to their tinnitus. Many studies have shown that this type of therapy reduces the perception of tinnitus for the majority of patients (reference documents).

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“ I have tried acupuncture, osteopathy, white noise and anxiety pills without any success. Using PAXX, I have diminished my tinnitus to a point that I do not pay attention to it. ”

– D. S., Telecommunication Technician

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More and more information

If you want to read more about tinnitus research, treatment and theory, read the following document

Scientific reference list